Democrats are focused on forcing the Republican-controlled Senate to vote for what they consider is a fair Trump impeachment trial, Republicans are focused on defending President Trump for killing Iran’s military terrorist General Soleimani. But H.R.3 is a matter more important than Trump’s impeachment trial or Iran’s revenge on America.


First published in January 2020.


H.R.3 deserves the priority attention of both Democrats and Republicans.

Critics of President Trump claim he ordered the killing of Iran’s General Soleimani to divert the country’s attention from his impeachment. If this is true President Trump is making a misjudgment about the priorities of American citizens.

53% of Americans have identified excessive drug prices as the chief issue that Congress should address in the next two years, meaning the true attention diverter from an impeachment trial can be found in H.R.3 the Elijah E. Cummings Lower Drug Costs Now Act of 2019, H.R.3 gives the Secretary of Health and Human Services the authority to directly negotiate the price of prescription drugs with all pharmaceutical companies.

The truth about insulin prices, Nov 2019. / Patients for affordable drugs

H.R.3 was voted on and passed by the House. It now sits idle waiting to be brought to the Senate floor for a final vote. While both a Trump impeachment trial and Iran’s revenge impact American society, neither has a direct impact on an American citizen’s life like H.R.3 and the cost of prescription drugs.

One in four Americans cannot afford to purchase the drugs they need to live. As a result, they turn to the lethal practice of drug rationing. One of the most egregious examples of life threatening price gouging that H.R.3 will stop is the cost of the prescription drug used to treat diabetes, insulin. It first became available to the general public over 90 years ago in 1922.

The truth about insulin prices, Nov 2019. / Patients for affordable drugs

Unlike most other American inventions whose retail cost to the buying public goes down over time, insulin defies those laws of gravity, the longer insulin stays around the price goes up it doesn’t come down.

Alec Raeshawn Smith aged off his mother’s insurance plan when he turned 26. The insulin for his diabetes was $1,300 a month without insurance. Alec died less than one month after going off her insurance and 3 days before his next payday. He was rationing his insulin trying to make it last until he could afford to buy more. The insulin pen found with his body was completely empty.

The following 4 reasons illustrate why H.R.3 is urgently needed and Alec had to pay $1,300 a month for a drug invented over 90 years ago:

1) Insulin Monopoly

Currently, Eli Lilly, Novo Nordisk, and Sanofi dominate more than 90% of the world’s insulin market. Often only one of them supplies insulin in a particular country, meaning they hold a monopoly there and can set prices as they wish. In 2 countries, China and India, there are domestic insulin companies that drive the price down considerably lower than what Americans pay. This demonstrates how more companies selling insulin in America would bring prices down.

The truth about insulin prices, Nov 2019. / Patients for affordable drugs

2) Shadow Pricing

Two lawsuits have been filed, one a class action suit filed by patients and the other brought by the State of Minnesota, alleging that all 3 companies fraudulently set artificially high list prices for their prescription drugs while offering rebates to pharmacy benefit managers (PBMs). The rebates are offered in exchange for the PBMs adding the company’s prescription drugs to the healthcare plans the PBMs represent. The lawsuits contend that shadow pricing makes insulin less affordable for diabetes patients in high deductible healthcare plans, the uninsured, and senior citizens covered by Medicare.

The truth about insulin prices, Nov 2019. / Patients for affordable drugs

3) Patent Ever Greening

Patent ever greening occurs when pharmaceutical companies take advantage of loopholes in the U.S. patent system by attaching new patents to the original 20 year patent. This prevents competition and keeps prices high for decades. Sanofi, the maker of Lantus, is a prime example of this greed tactic. It has filed 74 patent applications on their 90 year old insulin medication, which means Sanofi has created the potential for a competition-free monopoly for another 37 years. That’s almost twice as long as the generous 20-year exclusivity period given to reward companies for bringing new drugs to market.

4) Pay-For-Delay Agreements

Pay-for-delay agreements are patent dispute settlements in which a generic manufacturer acknowledges the original patent of a pharmaceutical company and agrees to refrain from selling its product for a specific period of time. In return, the company receives a payment from the patent-holder. This makes it legal for one insulin producer to pay another one not to enter the market and produce insulin.

A Senate impeachment trial is the appropriate response to a vote by the House to impeach President Trump, and it’s expected that a Republican-controlled Senate would defend the logic of President Trump’s kill order. But instead of the Senate complaining about how the House impeached President Trump or gloating about how no American soldiers were killed by Iran’s revenge, they should act now to SAVE AMERICAN LIVES.

The Senate should immediately make H.R.3 the law of the land to stop lethal drug rationing, monopoly price gouging, patent manipulation, and pay-for-delay agreements which will lower the cost of life saving prescription drugs for all Americans.🔷



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[This piece was originally published on Isaac Newton Farris Jr.’s blog and re-published in PMP Magazine on 9 January 2020, with the author’s consent. | The author writes in a personal capacity.]

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